Clinical Practice 3 (MLT-465)

L2

Introduction
Human infectious viruses

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Viral prosperities pit

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Virion structures

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The Baltimore Classification system

diploid

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CON. Baltimore Classification

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The Baltimore Classification
TSSDNA
D

A DNA

Rodipid

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The virus classification II
the classical system O

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The virus classification III
the genomic system

A
classical
Genomic
Baltimore

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Viral genome strategies

dsDNA
spin

a
jpg

set
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 Viral Infection
 Viruses have been shown to infect a wide variety
of living things, including plants, animals, and
even bacteria.

Each type of virus has its

favorite host or even a
favorite type of cell
within the host

Below is a chart showing different types of viruses and the parts of

the body that they typically infect in humans. Do you recognize any
of these viruses? Rabies? Herpes? Influenza?
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I

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 Basic structure
&
antigens of
Hepatitis viruses

Heptitic
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Hepatitis Viruses

AE
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13
enteric
 Hepatitis Viruses
 Viral hepatitis is a systemic disease primarily involving the
liver.
 Most cases of acute viral hepatitis in children and adults
are caused by one of the following five agents:
1. Hepatitis A virus ( HAV)
2. Hepatitis B virus (HBV)
3. Hepatitis C virus (HCV)
4. Hepatitis D (HDV)
5. Hepatitis E virus (HEV).

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 a
o

t
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 Hepatitis Type A
 HAV is a distinct member of the Family Picornaviridae
picornavirus family.
Genus Hepatovirus
 Is prototype of genus Hepatovirus .

et
27 nm,
 Antibody to HAV, Detectable at Virion
icosahedral
onset of symptoms; lifetime
persistence . Envelope No
 IgM class antibody to HAV, Indicates Genome ssRNA
recent infection with hepatitis A;
Genome size (kb) 7.5
positive result up to 4–6 months
after infection Stability
Heat and acid
stable
Transmission
Prevalence
Ee
Fecal–oral
High

Fulminant disease Rare

É
Chronic disease Never
Oncogenic No

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WEE rag aBÉA_
FEE
is 02-Sep-23
RNA
17

Ah
Hepatitis Terms

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 Hepatitis B virus: HBV
 HBV is classified as a hepadnavirus
P

 HBV sAg = Hepatitis B surface antigens

E
H
Anti-HBs or HBsAb = hepatitis B surface antibody

o
HBeAg = hepatitis B e-antigen

O
bad EE
Eod 02-Sep-23 19
HBV structure Labeling

dsDNA
00

Io oo
FEE
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ett
20
 HBV
Remember!
i

HBV virus contains HBV sAg,

8

HBC core and other antigens

 HBV Vaccine contains HBV sAg

ONLY

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 Serological markers for HBV infection

diver
of it
0

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 8 O
E o

o
core O
E O
8 e
In
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 Clinical case 1

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8

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 Clinical case 2

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Clinical case 3

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 Be

ignorant Clinical case 4

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0

on
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Clinical case 5

of
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 Hepatitis D
Classification Peltate
• HDV is the only virus in the genus, Deltaviridae.

• HDV is not classified into a viral family because it

is a unique virus dependent on HBV. HDV is a co-
infection of HBV.

• The envelope of HDV particles contains the

Hepatitis B surface antigen (HBsAg).

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 Serological test for HDV:
7
 Anti HDIgM,

8
 Anti HDIgG
 HDV RNA & HDAg A

awed
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 Hepatitis Type C

O
EE
d 0
Heparin
fat irons 02-Sep-23 be 31
 Y
HCV - Virology

FREE
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 Hepatitis C Genotypes
It
 Genotype- classification of the virus based
on genetic material
◦ May be broken down further into subtypes
Genot
Genotype Genoty
ype
3a, 3b, 3c, pe 5a
do
1 1b
1a, b
3d, 3e, 3f
a o Genot
ype 6a
Genoty
pe 2a,
Genotype 4a
4b, 4c, 4d, o
E
2b, 2c,
2d
4e, 4f, 4g,
4h, 4i, 4j
o
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d 33

bing.FM na
g
saba
 2d
33dg 12 24 36 9251 Gl

Lab diagnosis of HCV

 In acute infection, mild leukopenia, hyperbilirubinemia and


elevated transaminases may occur.
II eaters'd
HCV RNA detected in blood within 1 – 3 weeks of exposure.

 HCV antibodies present in 50 – 70% of patients at onset of

symptoms, and 90% at 3 months.

 Chronic inflammation of the liver with persistence of HCV

RNA > 6 months.

 Serologic tests to detect HCV antibodies:

- Enzyme immunoassay (EIA)

HIRE
-Recombinant immunoblot assay (RIBA)

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75
 EIA

Lab diagnosis of HCV I b

EL's

RNA
EEE s
pick
a Fire

and

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É

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Senestive

ELISA
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Retroviruses

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Properties of Retroviruses

start

DERNA mRNA

a
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 There are two distinct types of human AIDS viruses: HIV-1 and HIV-2.

 Based on gene sequences, HIV-1 comprises three distinct virus groups (M, N, and O);

the predominant M group contains at least 10 subtypes or “clades” (A–J).

 Within each subtype there is extensive variability.

Hi HN 2

to
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M
 A

Course of Humans HIV Infection IF

 Primary infection, there is a 4- to 11-day between mucosal
infection and initial viremia.
56 in days
o_O
 Viremia is detectable for about 8–12 weeks.
 Virus is widely disseminated throughout the body, and the
lymphoid organs become seeded.
An acute mononucleosis- like syndrome develops in 3–6 weeks
d


after primary infection.

Primary Virata lymph mono o

CD 4
Immune
D
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bri
 Course of HIV Infection Cont..


C
Drop in numbers of circulating CD4 T cells .
Immune response to HIV occurs 1 week to 3 months after infection, viremia
drops, and levels of CD4 cells rebound.
 Immune response is unable to clear the infection, and HIV-infected cells persist
in the lymph nodes. only

 Period of clinical latency last for as long as10 years.

 CD4 T lymphocytes, major targets responsible for virus production.

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Major Gene Products of HIV Useful in Diagnosis of Infection

80

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 Laboratory diagnosis of HIV
 Serology: Test kits are commercially available for measuring antibodies by

enzyme-linked immunoassay (EIA), positive test must be confirmed by a repeat

test.
ELISA Ag
 The most widely used confirmation assay is the Western blot technique.

O
o
o

PI cave

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Human infectious viruses

Herpesviridae

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 Characteristics of Herpesviruses

 DNA enveloped viruses

 They cause chronic, latent and recurrent infection

 Aprox 100 herpesviruses have been isolated to date

 Have large double DNA genome

ÉÉÉ
d

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Classification of Herpesviruses

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 88

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 Varicella-Zoster virus (VZV)

 Primary infection causes Varicella (chickenpox) after

which VZV becomes latent in the dorsal
o
root ganglia of sensory or cranial nerves.

 Herpes zoster (HZ) also known as

swales
shingles is a reactivation of the
g
Varicella-Zoster virus (VZV) g
I
us
to
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 cen
Cytomegalo virus
 Largest genome of the human herpesviruses

Immunity

Coo
IgM, IgG, IgA
 Virus becomes latent with episodes of recurrence
gÉ
Laboratory diagnosis g
D
 Virus isolation is slow - two to three weeks before CPE
 Serologic tests (ELISA) to detect CMV antibodies (IgM and
IgG)
 PCR

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 Epstein-Barr virus
cells
◦ Around 100 genes
X B

IT
◦ Targets B cells
coat
◦ Can also infect epithelial cells of oropharynx, parotid
gland, cervix

◦ Usually becomes latent in the B cell

◦ Can cause transformation

◦ Used to make immortalized human B cells thatmooncord

I
secrete monoclonal antibodies

ER
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 mediatory
Herpesviruses 6,7 and 8
HHV-6
Det
 Infects T cells
 Causes roseola
 Only a problem in immunocompromised
patients
HHV-7
M
 Infects T cells
 No known disease
HHV-8
 Kaposi’s sarcoma virus
 Before HIV disease, only known to cause
disease in men of Mediterranean descent and
chemotherapy patients
 Isolated from HIV patients

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HEE 52
Influenza viruses

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 IBE
 Influenza is an acute respiratory disease.

 Three types of influenza virus are known; A, B and C.quite

 Influenza A causes worldwide epidemics of influenza;

 B influenza causes outbreaks

 and C influenza causes mild respiratory disease.

epidemic
mild
A B c
b
out breath
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 sRNA
Influenza viruses HIA
The virus is a single stranded RNA virus.
The nucleocapsid is helical and is surrounded by a lipid
envelope which gives it a spherical shape.

 Two glycoproteins; the haemagglutinin (HA)

and the neuraminidase (NA) are inserted in the a
envelope. F
antigenic
geddit
anti
 These two glycoproteins are "important antigens
and determine antigenic variations in influenza
viruses

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HA - hemagglutinin

NA - neuraminidase Ad
helical nucleocapsid (RNA plus
NP protein)

lipid bilayer membrane

ap
polymerase complex

00
M1 protein
type A, B, C : NP, M1

88
protein
sub-types: HA or NA
protein

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Diagnosis

dnasopharyngeal swabs or sputum which are examined

• Specimens are nasal aspirates, throat or

by:
Elka examinent
dined
• Rapid detection of viral antigens in specimens using

a
commercially available kits that depend on ELISA and other
immunoassay methods.

• Isolation of virus in cell culture.

EYE
• Detection of viral RNA in clinical specimens by probes or PCR.

or
• Detection of rising antibody titer to the virus in serum
samples by hemagglutination inhibition, ELISA or RIA.

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I 59
00
8
6 I
coom
gamins
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 SERNA

I
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Newly emerged Corona viruses
 The first one was called SARS-CoV.

 Middle East respiratory syndrome

MERS-CoV.

 The running one nowadays is SARS

CoV -2

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 I
Q
i
Bets

MERS
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 I
I
I

serum
Bogd 02-Sep-23 65

Yerogogetectio
ET
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Arbo-Dengue, Zika
&
Ebola virus

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 Arthropod-borne
I Viruses

2 É
Arthropod-borne viruses (arboviruses) are viruses that
can be transmitted to man by arthropod vectors.

 Man - arthropod -man

 e.g. dengue, urban yellow fever.

 Animal - arthropod vector - man

 e.g. Japanese encephalitis, EEE, WEE, jungle
yellow fever.
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 Dengue classified
 Family: Flaviviridae
 Genus: Flavivirus
 Species: Dengue virus
• Arbovirus

of•• (Aedes
– Arthropod, Mosquito, born
aegypti)
It is a pathogen that causes
– Dengue fever (DF)
a fever (DHF)
– Dengue hemorrhagic k
•
3
Can lead to Dengue shock syndrome (DSS)
• Has four different serotypes (DEN-1,2,3,4)
• First reported epidemics in 1780 in Asia,
Africa, and North America

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Diagnostic tests
Detection of IgM antibodies in the blood by PCR or
48

Viral isolation (Serology)
es
 ELISA (Enzyme-Linked Immunoabsorbent assay)

 Thrombopenia

 Raised hematocrit
MIO

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 80

s
a
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 RT PCR

ELISA plague reduction neutilization

RIFF
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b
serologtig
 n

EBOLA VIRUS

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 EBOLA
An infectious
Named because of Ebola River
Generally fetal disease marked by
 fever
Severe internal bleeding

Spread throughout contacts with

Body fluids by Filovirus (Ebola
Virus)
Fruit Bats
HOST Are Major Cause For The
Transmission
Unknown Of Ebola Virus Disease

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 Diagnostic Tests rapid REITs
 Rapidblood tests for Ebola virus infection are the
most commonly used tests for diagnosis.
 Rapid blood tests detect specific RNA sequences by
e
reverse-transcription polymerase chain reaction (RT-
PCR)
Aa
Nabs
at
 Viral antigens detected (ELISA).

 Virus is generally detectable by RT-PCR between 3 to

10 days after the onset of symptoms.
e
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